We at Sherpaa wanted to write a little something about how Obamacare affects you. It’s exciting news in many, many ways. 


How will the Affordable Care Act affect you?

The Affordable Care Act, sometimes referred to as Obamacare, was officially passed in 2010, but will not be fully put into place until 2014.  There has been a ton of information about this act that has been made available, but we wanted to provide you with the top 6 elements of the act and how they affect you personally:

Summary of Benefits and Coverage

Health insurance plans are now required to provide you with an easy to understand summary about your specific health plan’s benefits and coverage information.  

Why You Care:  Healthcare can be super confusing.  We’ve all been there…it’s your first day of work, you have mountains of paperwork to fill out, and on top of it all, you need to select an insurance plan right away.  Oh, and they all look pretty darned similar.  With this new requirement, a lot of the confusion will be totally eliminated.

Preventative Care

Certain preventative services are now covered.  These include services such as blood pressure screenings, cholesterol screenings, depression screenings, HIV screenings for high risk adults, diet consultations for at risk adults, certain STD screenings for at risk adults, folic acid supplements for women who are pregnant, and mammograms for women over 40.

Why You Care:  Prevention is, very often, the best medicine.  It’s great to be able to take advantage of important preventative care and services that were previously super expensive or difficult to access.

Pre-Existing conditions

Health insurance companies can no longer deny healthcare coverage to people with pre-existing conditions.  

Why You Care:  People who want to purchase health insurance, either on their own or through their employer, should be able to afford to do so.  

Appealing Health Plan Decisions

Consumers now have the right to appeal health insurance plan decisions, particularly when a claim has been denied.  You will also now have the right to information from your insurance carrier such as the reason your claim was denied.

Why You Care:  Power to the people!  You will now have the opportunity to take more control of your health, and no longer be entirely at the mercy of the insurance companies.

Patients Bill of Rights

These include allowing young people under the age of 26 to remain on their parent’s insurance plan, eliminating the lifetime limits on coverage, eliminating arbitrary cancellation of coverage due to honest mistakes, forcing insurance companies to justify any truly egregious premium increases year over year,  and eliminates insurance company barriers to emergency care.

Why You Care:  Power to the people again!  A clear set of rights for consumers and expectations from insurance companies is a truly great thing.

Tax Credits for Small Employers 

Small businesses (fewer than 25 employees) and non profits will receive some tax credits (up to 50%) for purchasing insurance for their employees.

Why You Care:  Health insurance is expensive.  Any little bit of help is great for businesses as they continue to grow.

Birth Control

The Affordable Care Act allows for many types of birth control to be covered without co pays or deductibles.  Depending on the type of health insurance plan you have, this benefit either has already kicked in, or will be kicking in by 2014.   It should be noted that this is not for every type of birth control on the market.  Health plans are allowed to limit free coverage to some generic drugs/devices. To find out if your specific birth control is covered, go to your health insurance company’s website or call the member services 800 number located on the back of your insurance card.

Why You Care:  Birth control can be super expensive.  In some cases, this can mean more than $800 back in your pocket!

Mental Health

The Affordable Care Act now requires that mental health services be part of the “essential benefits package” that must be covered by certain plans.  This is great news for people who depend on these services.

Why You Care: This is a great benefit for people who require mental health care.  It should be noted, however, that many mental health professionals do not take insurance of any type.  This means that there may still be costs relating to this type of care.